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Following on from my previous mail in reply to Charles: Charles wrote: > > I don't know how the system is funded in Indonesia or European countr= ies > but Social Security is a tax in the US not an insurance program. The > funds are not invested they are using money of today's workers to pay > for elderly and disabled individuals. =20 If you want an idea of the way an authoritarian state can run, study Indonesia.=20 There is no support here, NOTHING, it makes one grateful for what is available in the west. Indonesia is an example of why I am concerned for personal freedom without coercion from the State in whatever form it takes. In Europe social security is often a percentage of income and, if you like, can be=20 considered a tax. I believe it is an insurance policy in essence and in the UK=20 is called National Insurance. It is meant to provide some basic security for=20 health, welfare and old age. Like the US there is pressure on the system mostly=20 from demographics, higher unemployment (whose fault is that - another argument) and higher expectations. Often the basic problem is people want something for nothing (in our point of discussion - I do not believe the claimant is asking=20 for something for nothing).The reason I look on it as an insurance is that one pays a sum of money which covers a whole range of situations eg unemployment, sickness, basic pension. An individual will take more or less according to what happens during=20 life, which more often or not is outside the individuals control. If someone=20 does not pay into the scheme then they are not a member - I presume our subject=20 did pay or has been deemed to have paid, and as such should be entitled to=20 the benefits. I agree with you (REALLY?? !!) there have to be limits, I am totaly against fraud, abuse of the system etc. These are theft and should be treated as such. Presumably, the subject of this discusion really hasPD and is not attempting fraud. > The current projections regarding > Soc. Security and medicare make it clear that the system will go broke > in the early 21st century. We don't have the luxury of a generous > definition of eligibility.=20 Funding is a real issue. I feel the problem is mixed up with peoples misunderstanding=20 of insurance (and social security). An American once said to me he didn't want to have mental health covered by his company policy because he was never going to have that problem, therefore he would never have any money back and therefore he begrudged=20 paying that portion of the premium. Insurance runs on an actuarial concept ie there=20 are a random number of people who will claim and a number who will not. The concept will not work if there is no random group. This fundamental flaw in understanding=20 (by the reluctant policy payer) goes hand in hand with the money for nothing attitude. With insurance, the luckiest person is the one who never claims. Politicians have cut back and cut back on taxes because people feel good about it on the day - they never think of tomorrow. This and choices of where taxes go is the real problem.=20 People are not prepared to accept the real cost, they expect something for=20 nothing. If you start bringing selection into health insurance, social security=20 where does it end, genetic testing etc? >> >> > Why should the goverment support Udall (if as a non American I>=20 > understand it)? Why don't PWP's pay for all the research themselves. > > Why do you expect consideration from others? We are not their> > resp= onsibility. > > >From solely the economic argument assuming that patients accepted th= e > results of the research, increased duration of productive employment, > decreased duration in total dependent situations- e.g. nursing home mak= e > it a good economic investment>=20 I wonder from a strict cost point of view if this is true. One needs to balance=20 the cost of an untreated situation with a treated scenario. How much does it cost=20 a company to have a disabled person in a job. I would expect quite a bit in=20 lost productivity etc. Can the company regain its loss from social security? > An insurance program must have criteria for benefits to be paid out- > otherwise it should be a savings program. =20 Call it a tax or what you will, the man has contributed. This is also a=20 government programme. Rules are often subject to interpretation and change. The government serves the people, not the other way. Governmen thas a moral=20 responsibility to include the whole spectrum of needs and that means everyone=20 (do you not treat sexually transmitted diseases, AIDS for instance - they are self inflicted? - no the lobby is too powerful and there are drug companies out=20 there waiting to make a killing on an AIDS cure) Criteria are often=20 changed, but normally for political motives. So, back to the point. Making certain basic assumptions: =B7 the guy is sick with PD =B7 he made contributions to the social security fund =B7 he did not contrive to have PD to obtain the benefit =B7 he should therefore expect some support If you do not accept this then maybe the next step of the social security officer=20 will be "you must have a pallidotomy" or "you must have a frontal lobotomy, you'll=20 feel a lot better and society won't have to pay so much for your upkeep". It's the=20 thin edge of the wedge, it's only a matter of degree. My God that's enough. Anyone who gets to this point deserves a merit award. Regards David